“The Coroner’s Office is a part of the Sheriffs Department and is under
the direction of the Sheriff’s Commander… The Coroner Unit’s
responsibility is to investigate all deaths reportable to the Coroner
and determine the cause, manner, and circumstances surrounding
reportable deaths. The (Sheriff) Coroner is a county-elected officer
acting under the authority of provisions of the California Government
Code and Health and Safety Code. There are specific laws that define the
Coroner’s powers and which vest in that person, the right and duty to
investigate certain classes of deaths. Taken from the Monterey County
Sheriffs Office website at
www.co.monterey.ca.us/sheriff

Not all deaths
are reportable to the Coroner. Those deaths that are reportable fall
into 25 categories. Those categories are:

1. No physician
in attendance.

2. Medical attendance less than 24 hours (hospital or residence).

3. Wherein the
deceased has not been attended by a physician in the 20 days prior to
death.

4. Wherein the physician is unable to state the cause of death.

5. Known or suspected homicide.

6. Known or suspected suicide.

7. Involving any criminal action or suspicion of a criminal act.

8. Related to or following a known or suspected self-induced or criminal
abortion.

9. Associated with a known or alleged rape of crime against nature.

10. Following an accident or injury, old or recent, (primary or
contributory, occurring immediately or at some remote time.)

14. Known or suspected contagious disease constituting a public health
hazard, including AIDS.

15. All deaths in operating rooms.

16. All deaths where the patient has not fully recovered from an
anesthetic whether in surgery, recovery room or elsewhere.

17. All deaths wherein the patient expired within 24 hours of an
operation or surgical procedure.

18. All deaths in which the patient was comatose throughout the period
of the physician’s attendance, whether at home or hospital.

19. All solitary deaths.

20. All deaths of unidentified persons.

21. All deaths where the suspected cause of death is Sudden Infant Death
Syndrome (Crib Death).

22. All deaths in prison, jails or of persons under the control of a law
enforcement agency.

23. All deaths of patients in state mental hospitals.

24. Wherein there is no known next of kin.

25. Fetal deaths of older than 20 weeks gestational age.

Is an Autopsy Needed?

Once a death is
reported to the Coroner, it is the Coroner’s responsibility to
investigate the death and the determinations as outlined above. From
this point, the Coroner may close the case as a “Physician Certified
death” meaning that a physician has reviewed the circumstances and
deemed that the death was of obvious natural cause. Only a fraction of
the deaths reported to the Coroner result in a full autopsy.

While many may
object to autopsy for religious or other reasons, some of which are
discussed below, there is an argument for the continuation of autopsies
and even the expansion of autopsies performed. Dr. Richard Horowitz,
Professor of Pathology at UC and UCLA School of Medicine, states that
“In up to 40% of autopsies, there is some finding that was not
clinically suspected, and in many of those cases, the patients' lives
might have been prolonged had the diagnosis been made. Yet, there is no
outcry; no one seems to care that so few autopsies are now done.” Dr.
Horowitz goes on to state that “Clinicians don't care because they fear
that autopsies may expose their mistakes. Many pathologists don't care
either -- autopsies take time and are not reimbursed. Hospitals and
health systems don't care because autopsies don't improve their ‘bottom
lines.’"

In those deaths
where the Coroner needs further investigation, the coroner or medical
examiner has the legal authority to order an autopsy without the consent
of the deceased person's family (next of kin). If an autopsy is not
required by law, it cannot be performed until the deceased person's
family provides permission.

Family members
may have concerns and strong emotions about an autopsy being done on a
loved one. It is important that the family understand that the autopsy
is a medical procedure performed respectfully and carefully, to
objectively evaluate disease or injury that may be present and to
determine the cause and manner of the loved one's death.

Issues for the
family to consider when a loved one is to be autopsied are:

2. If a family requests an autopsy, the consent form generally describes
the details of the autopsy, especially with respect to retention of
organs and tissues for teaching. The requesting family member should
make sure that the details of the autopsy are fully understood.

3. A family can request that a hospital do an autopsy on a person who
died there. In some hospitals, there is no charge for this service. In
some teaching hospitals, a person who died outside of the hospital (for
example, at a nursing home or at home) may be autopsied at the hospital
at no charge. If an autopsy is required by law, there is no charge to
the family. However, charges should be clarified before the procedure is
performed since many hospitals charge for autopsies and insurance
generally does not pay for autopsies.

4. An autopsy does not prevent the body from being viewed in an open
casket. Generally, none of the incisions made during the autopsy will
show after the body is prepared for viewing. The rare exception to this
is with autopsies in which injuries on the face, scalp, or hands are
evaluated. These autopsies may leave some marks that are visible during
viewing of the body.

5. If an autopsy is being performed at the request of the family, the
family may request that the examination be restricted or limited to
certain parts of the body. It is important to discuss these restrictions
with the pathologist to ensure that the requested examination allows the
pathologist to answer the family's questions about the death.

6. Autopsies to determine natural causes of death are not done as often
now as they were in the past. However, when death has most likely
occurred from natural disease, an autopsy can uncover information that
is very valuable to the deceased person's doctor and family.

7. Autopsy results may affect insurance settlements or result in legal
action

The Coroner may also take charge of any and all personal effects of the
decedent at the scene of the death and safeguard them until lawful
disposition can be made. The Coroner may also notify family of the
death.

The Coroner’s
Unit and County Public Administrator office work together to ensure that
indigents are buried, or by Board of Supervisors resolution in Monterey
County, cremated. If estate funds are available to pay for the burial or
cremation and the Public Administrator is administering the estate, the
Public Administrator will make arrangements to pay the costs of burial
or cremation from the estate. If no estate funds are available, the
Coroner Unit is responsible to see that this duty is carried out at
county expense.

The Public
Administrator acts as administrator in estates where there are assets to
distribute, no known estate plan (Will or Trust) and no immediately
known heirs or next of kin can be found.

What About Religious Belief or Cyrogenic Freezing?

Some people may
have an objection to autopsy due to religious belief or, as is becoming
more and more popular today, some may want to be cryogenically frozen
for resurrection at a later time. If the Coroner or Medical Examiner
requires that an autopsy be performed, this may undermine arrangements
made with regard to cryogenic freezing. Younger decedents are
particularly at risk of autopsy since death at a young age is most
likely to be the result of an accident, homicide, or sudden unexplained
illness.

Some state
legislators (California being one of those States) have moved toward
restricting the power of the state to demand an autopsy. One statute
which has been passed in at least five states (California, Maryland, New
Jersey, New York, and Ohio) is the "Religious Objection to Autopsy."
Simply, it gives people the right to attempt to prevent an autopsy of
their remains by signing a certificate declaring that autopsy is
contrary to their "religious belief." (A person completing such a form
is not required to state what his/her religion is.)

In states that
have passed a religious objection law, this form may be the most
effective way to prevent autopsies and to limit the scope of those which
are performed. If you or your family objects strongly to autopsy due to
religious or other reasons, you may consider executing the
California Certificate of Religious Belief attached. Remember, with
this form as with all legal documents, work with your attorney to make
sure it fits into your overall estate planning.

Keep in mind
that the Coroner or Medical Examiner will not request an autopsy unless
there is a clear and convincing reason for them to do so. If you execute
a Certificate as mentioned above, you may be losing an opportunity for
your family to benefit from the knowledge of a clearly diagnosed medical
issue that may be hereditary or you may be “burying” evidence of some
wrongdoing that would have otherwise been discovered and possibly
prosecuted.